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The Impact of Inpatient Palliative Care Consultations on 30-Day Hospital Readmissions.
- Source :
-
Journal of palliative medicine [J Palliat Med] 2015 Nov; Vol. 18 (11), pp. 956-61. Date of Electronic Publication: 2015 Aug 13. - Publication Year :
- 2015
-
Abstract
- Background: Inpatient palliative care consultations have been shown to reduce acute care utilization by reducing length of stay, but less is known about their impact on subsequent costs including hospital readmissions.<br />Objective: The study's objective was to examine the impact of inpatient palliative care consultations on 30-day hospital readmissions to a large urban academic medical center.<br />Methods: The hospital's electronic medical record system was used to identify all live discharges between August 2013 and November 2014. After adjusting for a propensity score, readmission rates were compared between palliative care and usual care groups.<br />Results: Of the 34,541 hospitalizations included in the study, 1430 (4.1%) involved a palliative care consult. After adjusting for the propensity score, patients seen by palliative care had a lower 30-day readmission rate-adjusted odds ratio (AOR) 0.66, 0.55-0.78; p<0.001. Adjusted rates were 10.3% (95% confidence interval [CI] 8.9%-12.0%) for palliative care and 15.0% (95% CI 14.4%-15.4%) for usual care. Among all palliative care patients, consultations that involved goals of care discussions were associated with a lower readmission rate (AOR 0.36, 0.27-0.48; p<0.001), but consultations involving symptom management were not (AOR 1.05, 0.82-1.35; p=0.684).<br />Conclusions: Palliative care palliative care consultations facilitate goals discussions, which in turn are associated with reduced rates of 30-day readmissions.
- Subjects :
- Cost Control methods
Electronic Health Records statistics & numerical data
Female
Hospitals, Urban statistics & numerical data
Humans
Length of Stay economics
Length of Stay statistics & numerical data
Logistic Models
Male
Middle Aged
Odds Ratio
Palliative Care statistics & numerical data
Patient Readmission statistics & numerical data
Propensity Score
Referral and Consultation economics
Referral and Consultation statistics & numerical data
Hospitals, Urban economics
Palliative Care economics
Patient Readmission economics
Subjects
Details
- Language :
- English
- ISSN :
- 1557-7740
- Volume :
- 18
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of palliative medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26270277
- Full Text :
- https://doi.org/10.1089/jpm.2015.0138